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HISTOLOGY OF THE LARYNX,

BRONCHI, AND LUNGS


Nicanor B. Lacuesta Jr. MD, DPBO-HNS
Larynx
• Reinforced by cartilage
– Hyaline: thyroid, cricoid, inferior arytenoid
cartilages
– Elastic: epiglottis, cuneiform, corniculate, superior
arytenoid cartilages
LARYNX
• Epiglottis – has a lingual and laryngeal surface
– Stratified squamous epithelium – lingual surface
and apical portion of the laryngeal surface
– Pseudostratified columanar ciliated epithelium –
laryngeal surface
– Mixed mucous and serous glands – beneath the
epithelium (lamina propria) – pockmarks in the
elastic cartilage
Larynx
• False vocal cords – respiratory epithelium -
serous glands in the lamina propria
• True vocal cords – stratified squamous
epithelium
– Vocal ligament – parallel bundles of elastic fibers –
support free edge of the fold
– Vocalis muscle – skeletal muscles
Trachea
• Composed of 16 to 20 rings of hyaline
cartilage
• Gap bridged with smooth muscle with
fibroelastic ligament - cough reflex
• Composed of several cells
Trachea
• Respiratory mucosa – unsually thick basal
lamina, with numerous goblet cells
– Ciliated cells – microvillous border – apex – cilia
projects
– Apical cytoplasm – number of mitochondria, a
small Golgi complex, not too extensive SER, few
ribosomes
– Goblet cells – similar in appearance to those in the
nasal cavity
Trachea
• Brush cells – slender columnar cell with a
luminal border of microvilli (2 µm)
– actin filaments extend apical cytoplasm
– No secretory granules
– Small aggregation of glycogen in the cytoplasm
– Unknown function – depleted goblet cells or
intermediate stages of differentiation of base cells
Trachea
• Serous cells – similar to those found in the
acini of bronchial submucosal glands
– Electron dense apical granules
– Produces a secretion of lower density than that of
mucous cells

• Basal cells
Trachea
• Kulchitski Cell – electrolucent cytoplasm
– Resemble argentaffin cells between cell lining the
crypts of the intestinal mucosa
– Numerous dense dense cored vesicles – clear halo
betweem the core and limiting membrane
– Vesicles are concentrated in the basal lamina
– Several categories (catecholamines, peptide
hormone secreteing cells)
Trachea
• 30% - epithelium of the upper trachea
• 28% - goblet cells
• 29% - basal cells
• Upper to lower trachea – increase in number
of ciliated cells and a decrease in goblet and
basal cells
Trachea
• Migratory cell – lymphocytes and globule
leukocytes
– Globule leukocytes – resembles mast cells,
variable number of metachromatic granules (0.1
to 0.3 µm), round or irregular in outline, function
is unknown
Trachea
• Bronchial submucosal glands – found in the
lamina propria
– First part is lined by epithelium similar to that of
the bronchial tree (short ciliated about 350 µm) –
continuous with…
– collecting duct (about 800 µm) – secretory tubules
arise, lined by columnar cells that interdigitate
along their lateral borders
Trachea
– Few dense apical granules
– Well developed Golgi complex
– Cytoplasm – large mitochondria with numerous
cristae – regulate water and electrolyte
composition of the glycoprotein secretrory
product of the gland
– Secretory tubules branch and terminate in a
cluster of tubules or acini
– Secretory tubules lines by columnar mucous cells
– Acini are lines with pyramidal serous cells (nuclues
in the base, secretory granules in the apex)
– Granules in the serous cells are discrete and
electron dense while those in mucous cells are
electron-lucent and confluent
– Myoepithelial cells – bases of secretory cells
Trachea
– Secretion of blanket mucous - trapping inhaled
particles, protects conducting airways from toxic
fumes
– Smoking: cessation of beating of the cilia, increase
in goblet cells, enlargement of submucous glands,
change in composition of secretory products
Bronchial Tree
• Bronchial histology = tracheal histology
• Structure of bronchi is very similar until it
enters the lungs
– Rings become plates or irregular outline
– Smooth muscles become more prominent
(circular or interlacing)
– Epithelium is simmilar to the trachea – glands
decrease in number at the terminal
– Height of epithelium diminishes (cuboidal)
Bronchial tree
BRONCHIOLES
– No plates in their wall
– No glands in the lamina propria
– Smooth muscles becomes bundles
– No goblet cells
– Epithelium both cilited and non-ciliated bronchial
cells (Clara cells)
Bronchial tree
• Clara cells - columnar cells with a rounded
apex
– Surface covered with microvilli
– Apical cytoplasm covered with dense secretory
granules
– Surface: joined by zonnulae occludentes
– Below surface: membranes diverge and have
processes in the intercellular spaces
Bronchial tree
– Centrally located nucleus – ovoid
– A Golgi complex above or beside the nucleus
– Long slender mithochondria and strands of RER
– No SER
– Functions:
• Secretion of surfactant
• Detoxification
• Secretion of antimicrobial peptides
• Replacement of other bronchial cells (stem cell
population)
Bronchial tree
• RESPIRATORY BRONCHIOLES – lining is
cuboidal to low cuboidal
– Non-ciliated in distal parts
– With interruptions of alveoli in the proximal
portions
Bronchial tree
• ALVEOLAR DUCTS – sacs become more
numerous
– Septum between sac are covered with bronchial
epithelial cells with overlying strands of smooth
muscles
Alveoli
• Thin walled sacular components
• 200 to 500 million
• Gas exchange
• Total area of 75 m2
• Rounded or polygonal in shape
• 200µm in diameter
• Septum with dense capilliary network with
reticular and elastic fibers, scattered fibroblasts
Alveoli
• Over the capillaries, air is separated from the
blood by the respiratory membrane or the
blood-air barrier (0.1-1.5 µm)
• Components of the blood-air barrier:
– 2-3 highly attenuated cells lining the alveoli
– Fused basal laminae of these cell and of the
capillary endothelial cells
– Thin endothelial cells of the capilliary
Alveoli
• Squamous alveolar cells (Type-I alveolar cells)
– Less than 0.2 µm thick
– Perinuclear cytoplasm contains a small Golgi
complex, few mitochondria, occasional RER
– Make up 10% of cell population but occupy 95%
of total alveolar surface
Alveoli
– Thickness of these cells are as little as 25 nm due
to clustering of organelles around the nucleus
– Attached to neighboring cells by occluding
junctions
– Smooth apical surface
Alveoli
• Great alveolar cells (Type-II alveolar cells)
– 12% of cell population and 5% of alveolar surface
– Located at the angles of neighboring alveolar
septa
– Thicker with a rounded apical surface
– Free surface is covered with short microvilli
– Nucleus is slightly irregular in outline
– Golgi complex, mitochondria
Alveoli
– With lamelar bodies – dense ovoid membrane
bound granules (1-2 µm)
– Synthesize and secrete pulmonary surfactant
(lamellar bodies – secretory granules)
– Pulmonary surfactant components
• 80-90% phospholipid (dipalmotylphosphatidylcholine,
DPPC)
• 10% surfactant specific protein
• cholesterol
Alveoli
– 4 types surfactant specific protein
• Surfactant protein A (SP-A) – very abundant hydrophilic
glycoprotein
• Surfactant protein B (SP-B) – required for the
maturation of DPPC
• Surfactant Protein C (SP-C) – required for the
maturation of DPPC
• Surfactant protein D (SP-D) – innate immune protection
Alveoli
• Alveolar septa = interstitium of the lung
– Septal cells (interstitial fibroblasts) – most
abundant cell in the interstitium, have long
branching processes, with gap junctions, lipid
droplets, and bundles of actin filaments
(myofibroblasts) – produce type III collagen,
elastin and proteoglycans
– Mast cells
– lymphocytes
Alveoli
• Pores of Kohn – openings between adjacent
alveoli, 10-15 µm in diameter, responsible for
collateral respiration
• Collagen wreaths at the opening of alveoli and
continuous with those of neighboring alveoli -
gives support to alveoli
alveoli
• Alveolar macrophages (dust cells) – free cells
migrating over the luminal surface
– 15 to 40µm in diameter
– Irregularly shaped nucleus
– Prominent nucleolus
– Highly vacuolated cytoplasm and a small Golgi
complex
Alveoli
– Prominent filopodia and lamellopodia, a large
number of membrane bounded inclusions in the
cytoplasm
– Rich hydrolytic enzymes
– Specific activitites of acid phosphatidase,
glucuronidase, and lysozyme are higher than
those macrophages elsewhere in the bodies
– Orginated from the bone marrow stem cells and
are transported as monocytes in the blood
Alveoli
– First line of defense
– Surface receptors of IgG and C3b component of
the complement system
– Ultimately, three fates
• Migrate into bronchioles where they are removed by
ciliary activity
• Removed via lympahtic drainage
• Remain in the alveolar septa for years
alveoli
• Alveolar lining fluids are removed via the
conductive passages as a result of ciliary
activity – combine with bronchial mucus –
bronchoalveolar fluid
• Bronchoalveolar fluid
– Removed particulates from air
– bacteriostatic
Alveoli
• Regeneration in the Alveolar Lining
– Death of the first cells results in increased mitotic
activity in the remaining type II cells - become
both cell types.
– normal turnover rate of type II cells is 1% per day
– results in a continuous renewal of both alveolar
cells.
– With increased toxic stress, some Clara cells can
also be stimulated to divide and give rise to
alveolar cells.
Pleural Membranes
• Viceral pleura – surface of the lungs
• Parietal pleura – thoracic walls
• Composed of squamous mesothelial cells on a
this connective tissue layer (collagen and
elastic)
• Produces thin film of serous fluid - lubricant