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THE RESPIRATORY SYSTEM

Learning Objectives: Understand the differences between the conducting and respiratory portion of the
respiratory system. Define the roles and composition of these two regions.
Key Words: Conducting, respiratory, alveoli, cartilage, trachea, bronchus, bronchioles, vocal cords.

The respiratory system


The means by which, through a system of tubes, the body exchanges carbon dioxide for oxygen, which is
then distributed throughout the body.
2 Parts: An upper conducting portion and a lower respiratory portion.

A. CONDUCTING PORTION
Consists of the extra-pulmonary nasal cavity, nasopharynx, larynx,
trachea, bronchi and the intrapulmonary bronchi, bronchioles and
terminal bronchioles.
It serves two main roles:
1. To provide a conduit through which air can travel to and from
the lungs
2. To condition the inspired air.

Components of the Conducting System


Cartilage (primarily hyaline) from C-shaped rings to irregular rings
and small plaques. Prevents collapse of the walls.
Collagen fibers
Elastic Fibers: Tend to be oriented longitudinally in this area.
Smooth muscle: From trachea to alveolar ducts. Contraction
reduces diameter of tubes and restricts airflow

Respiratory Epithelium
Lines the conducting portions
Ciliated, pseudostratified columnar epithelium
Does not mediate gas exchange.
Functions to cleanse, moisten and warm air before it enters
the lungs.
Numerous serous and mucous glands and a rich superficial vascular network in lamina propria.
Goblet cells, producing a rich mucous secretion, abundant in the upper portions of the conducting
tubes.
The number of goblet cells, along with the amount of ciliated epithelium and cartilage, decrease
as the conducting tubes gradually proceed into the respiratory portion.
At the same time the content of smooth muscle and elastic fibers progressively increases.
Ciliated pseudostratified columnar epithelium transitions to a simple columnar and finally a
simple squamous epithelium in the alveoli.
The rich goblet cell population tapers off in the smaller bronchi and these cells are absent from
the terminal bronchioles.
Ciliated cells continue beyond the goblet cells, preventing the accumulation of mucous.
Cilia move fluid and mucus toward the oral cavity where it is swallowed or expectorated.
Respiratory epithelium consists of 5 cell types:
1. Ciliated columnar cells; Most abundant, each having about 300 cilia on their apical
surface. Many apical mitochondria provide energy for beating.
2. Mucous goblet cells; Contain polysaccharide-rich mucous droplets.
3. Brush cells; Many microvilli on their apical surface and afferent nerve endings on their
basal surfaces; considered to be sensory receptors.
4. Basal (short) cells; Small round cells lie on the basal lamina, do not extend to the
luminal surface. Believed to be generative cells and give rise to other cell types by
mitosis.
5. Small granule cells; Resemble the basal cell but contain numerous dense granules and
form part of the diffuse neuroendocrine system.
Table 1

CONDUCTING RESPIRATORY
Nasal Larynx Trachea Bronchi Bronchioles Alveoli
Large Small Large Small
Epitheliu Pseudo/ Pseudo/ Pseudo/ Pseudo/ Pseudo/ Pseudo/ Simple/ Simple/
m columna columna columna columna columna columna cuboid Squamous
r r r r r r
Cilia +++ +++ +++ +++ +++ +++ +++ ---
Goblet +++ +++ +++ ++ + + --- ---
Glands +++ +++ ++ ++ + --- --- ---
Cartilage + + +++ ++ + --- --- ---
Muscle --- --- + + + ++ + ---
Elastic --- + + ++ ++ ++ ++ +++
B. RESPIRATORY PORTION
Consists of alveolar ducts, sacs and pores.
Gas exchange occurs between the alveolar and capillary lumen, across the squamous epithelium of
alveolar pneumocytes and the capillary endothelium.
NASOPHARYNX
First part of the pharynx, continuous with the oropharynx.
It is lined with respiratory epithelium where it is in contact with the soft palate.

BRONCHIAL TREE
The trachea divides into two primary bronchi.
After entering the lungs the primary bronchi give rise to lobar bronchi which supply a
pulmonary lobe. There are three lobar bronchi in the right lung and two in the left.
Lobar bronchi divide repeatedly giving rise to smaller bronchi whose termini are the bronchioles.
Each bronchiole enters a pulmonary lobule where it branches to form 5-7 terminal bronchioles.
Primary bronchi histologically resemble the trachea however as one proceeds towards the
respiratory portion the epithelium and lamina propria become simplified.

Bronchi:
Bronchial diameter decreases.
Cartilage rings are replaced with isolated
plates, or islands, of hyaline cartilage.
In the lamina propria are bundles of smooth
muscle which become more prominent near
the respiratory zone.
The lamina propria also contains many
elastic fibers, abundant mucous and serous
glands and many lymphocytes along with
lymphatic nodules.

Bronchioles:
Intralobular airways with diameters of
5mm or less.
Mucosa contains no glands or cartilage.
In the larger bronchioles the epithelium is
ciliated pseudostratified columar which
decreases in height to become ciliated
simple columnar or cuboidal epithelium in
the terminal bronchioles.
Within the terminal bronchioles the
epithelium also contains Clara cells. These
cells have no cilia but contain secretory
granules and secrete glycosaminoglycans
that serve to protect the epithelium.
The lamina propria contains mainly smooth muscle
and elastic fibers.

Respiratory Bronchioles:
Each terminal bronchiole divides into 2+ respiratory
bronchioles where the conducting portion transitions
into the respiratory portion.
The mucosa of the respiratory bronchioles resembles
that of terminal bronchioles except the walls are
interrupted by numerous saccular alveoli, sites of gas
exchange.
At the rim of the alveolar openings the ciliated
cuboidal epithelium becomes continuous with the
squamous alveolar lining cells.

Alveolar Ducts:
Where the number of alveolar openings increases to the point that the bronchial wall disappears
the tube.
Squamous alveolar cells line alveolar ducts and alveoli.
In the lamina propria, around the rim of the alveoli, is a network of smooth muscle cells that
appear as knobs between adjacent alveoli. This smooth muscle disappears at the distal ends of the
alveolar ducts.
Alveolar ducts open into atria, which communicate with alveolar sacs.
A Complex networks of elastic and reticular fibers encircle the atria, alveolar sacs and alveoli.

ALVEOLI
Saclike structures about 200M in diameter.
Approximately 300 million of these with a surface area of 140m 2 form the spongy structure of the
lungs.
Within these specialized structures oxygen and carbon dioxide are exchanged between air and
blood.
Each alveoli wall usually lies between two neighbouring alveoli and is called an inter-alveolar
septum.
An alveolar septum consists of two thin squamous epithelial layers between which lie capillaries,
fibroblasts, elastic and reticular fibers and macrophages.
The capillaries and the connective tissue form the interstitium. This interstitium contains the
richest network of capillaries within the body.
The inter-alveolar septum may contain one or more pores known as the pores of Kohn. These
pores connect neighbouring alveoli and can equalize pressure or allow collateral circulation when
an alveolus is blocked.
Alveolar macrophages can also pass through these pores.
Air in the alveoli is separated from blood in the capillary by three components called the blood-
air barrier:

Components of the blood-air barrier


1. Surface and cytoplasm of the alveolar cells.
2. Fused basal laminae of the alveolar cells and the capillary endothelial cells;
3. The cytoplasm of the endothelial cells.
The total thickness of this barrier varies from 0.1-1.5M. Reticular fibers within
the septum act as support for the anastomosing capillary network.
Oxygen from the alveolar air diffuses through the layers of the alveolar septum
whilst carbon dioxide diffuses in the opposite direction.

The inter-alveolar septum consists of 5 main cell types:


1. Capillary endothelial cells, very thin and non-fenestrated.
2. Type I alveolar (squamous) pneumocytes. Very attenuated cells, 97% of the alveolar surface. All
have desmosomes and tight occluding junctions so form a gas permeable barrier of minimal
thickness.
3. Type II pneumocytes. Interspersed among the type I cells. Roughly cuboidal and usually found in
groups of 2-3 at points where the alveolar walls unite and form angles. Resemble secretory cells
with a well-developed Golgi network and microvilli on their apical surface. They have a foamy,
vesicular cytoplasm caused by the presence of lamellar bodies containing lipid,
glycosaminoglycans and protein. These lamellar bodies are continuously synthesized and released
from the apical surface providing an alveolar coat or pulmonary surfactant that lowers alveolar
surface tension.
4. Interstitial cells including fibroblasts and mast cells. Fibroblasts synthesize collagen, elastic
fibers and GAGs. Collagen and elastic fibers add resilience and elasticity to the mechanical
properties of the lungs.
5. Alveolar macrophages or Dust cells. Derived from monocytes. Can be found in the interior of
the septum or on the surface of the alveolus. They can often contain large amounts of carbon and
dust, which they phagocytose from the alveolar lumen.
PULMONARY BLOOD VESSELS
Systemic (bronchial) system:
Follows the bronchial tree and supplies nutrients to the lung tissue up to the respiratory
bronchioles.
At this point these vessels anastomose with the small branches of the pulmonary artery and return
blood via the pulmonary vein.
Bronchial arteries branch from the aorta and thus carry blood at systemic pressure. Bronchial
arteries have smaller lumens and thicker walls than pulmonary arteries. Their walls contain a
distinct elastic lamina and a muscular media.

Functional (pulmonary) system


Pulmonary arteries are low-pressure vessels with thin walls.
These vessels have an internal elastic lamina, smooth muscle and elastic fibers.
Within the lung the pulmonary artery branches following the bronchial tree. At the level of the
alveolar duct the branches form a capillary network in the inter-alveolar septum.
Venules originate from the capillaries and enter the interlobular septum finally leaving the lobule
to follow the bronchial tree to the hilum.
PULMONARY LYMPHATIC VESSELS
These follow the bronchi and pulmonary vessels and can occur in the interlobular septum.
All drain into lymph nodes at the hilum.
No lymphatics in the terminal portion of the bronchial tree or beyond the alveolar ducts.

PLEURA
A serous membrane covering the lungs.
It consists of two layers, parietal and visceral, which are continuous at the hilum.
Both membranes consist of a thin squamous mesothelium resting on a connective tissue layer
containing collagen and elastic fibers. Under normal circumstances the space between these two
layers is filled with a layer of fluid that acts as a lubricating agent.

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